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Oregon Medical Insurance > Kaiser Permanente of Oregon > HSA $2600 Benefits

HealthNet Health Plans

Kaiser Permanente
for Individuals and Families
$2,600 deductible with HSA Option
without Rx plan
$2,600 deductible with HSA Option
with Rx plan
Annual Individual deductible
$2,600 member
$5,200 per family
$2,600 member
$5,200 per family
Lifetime benefit maximum
$2 million
$2 million
Annual out-of-pocket maximum
Not all copayments count toward your limit; not all copayments are waived after limit is met.
$5,000 member
$10,000 per family
$5,000 member
$10,000 per family
Hospital care (including maternity care)*
Members pay
Members pay
All inpatient care is covered after payment of applicable copayments. There are no limits on prescribed hospital days.
20% coinsurance†
20% coinsurance†
Office visits*
Members pay
Members pay
For diagnosis and treatment by primary care providers, consultation and treatment by specialists, routine physical and hearing exams, well-baby visits through age 2, prenatal care, eye exams, and urgent care.
20% per primary care visit†
20% per specialty care visit†
20% per primary care visit†
20% per specialty care visit†
Outpatient Rx drugs
Members pay
Members pay
When prescribed by a Kaiser Permanente physician or a licensed dentist in accordance with our formulary process.
Not covered
$15 generic Rx
$30 brand-name Rx
(30-day supply)
Other Benefits
Members pay
Members pay
Laboratory
Inpatient and outpatient.
20%‡
20%‡
X-rays and other special procedures
Inpatient and outpatient.
20%‡
20%‡
*Emergency care
 Within and outside Kaiser Permanente Service Area
20% coinsurance (after deductible)**
20% coinsurance (after deductible)**
* Plus any copayments or coinsurance for lab or X-ray
** The emergency care copay will be waived and the hospital copay will apply if admitted directly to hospital from an emergency room. Additional copayments or coinsurance may apply for lab, X-ray, etc.
† (After deductible) Deductible waived for well-baby visits, prenatal care, and certain preventive procedures.
‡ (After deductible) No deductible for preventive tests or preventive procedures.

This benefit summary lists the copayments you pay for services. This summary is not a contract but a general listing of major benefits, exclusions, and limitations.  Your particular benefits are those contained in the Kaiser Permanente Personal Advantage membership agreement, which you will receive if accepted.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 
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